Provider Demographics
NPI:1346674934
Name:ADULT FAMILY CARE HOME
Entity Type:Organization
Organization Name:ADULT FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:ST.HILLAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-621-2269
Mailing Address - Street 1:1320 NW 171ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5215
Mailing Address - Country:US
Mailing Address - Phone:305-621-2269
Mailing Address - Fax:305-621-2269
Practice Address - Street 1:1320 NW 171ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-5215
Practice Address - Country:US
Practice Address - Phone:305-621-2269
Practice Address - Fax:305-621-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906350311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home